From paper charts to proactive care: A discussion about AI’s role in the future of primary medicine.
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Primary Medicine Podcast
In his interview with Dr. Dimitre Ranev on the Primary Medicine Podcast, Mike Checkley, President of Accuro, shared his journey from university programmer to healthcare technology leader. He offered a compelling look at how digital tools, and AI in particular, are reshaping the future of clinical care in Canada.
From Paper to Platform
Accuro EMR began as a university project in 2003, when Mike and two classmates set out to solve real-world problems using their computer science skills. Their first client was a chaotic, paper-based specialist clinic. The moment that sparked their mission? A towering stack of referral letters on a physician’s desk—each one representing a patient waiting to be seen.
“We need to get this stuff all in a computer to better organize this practice.” —Mike Checkley
That insight launched a 20-year journey to build one of Canada’s leading EMRs.
The Evolution of EMRs
Mike described the digital transformation of clinics in three phases:
- Paperless: Moving from paper charts to digital records.
- Electronic: Using EMRs not just for documentation, but for structured data.
- Proactive: Leveraging that data to drive better care, like sending batch reminders to patients overdue for screenings.
Accuro’s built-in query builder allows clinics to identify patient cohorts (e.g., diabetics without recent A1Cs) and send targeted messages through the patient app, Medeo Patient.
The Five Levels of AI Integration
In talking about how AI tools are and will be integrating into AccuroEMR, Mike outlined a five-level framework for this evolution in clinical settings:
- Level 1: Scribing & Summarization
AI tools record conversations and generate clinical notes, patient summaries, and even pre-visit EMR overviews, reducing or eliminating manual typing. - Level 2: Data Entry
AI extracts structured data from notes and updates the patient’s history with new problem lists, allergies, etc. It may even use that data to identify billing codes and take care of billing as well. - Level 3: Automated Actions
AI initiates tasks like lab orders, prescriptions, referrals, and follow-ups. This reduces administrative burden and ensures necessary actions happen immediately. - Level 4: Population Health
AI identifies care gaps and automates outreach, helping clinics manage their roster as a population. - Level 5: Clinical Decision Support
The most advanced (and controversial) level: AI offering diagnostic or treatment suggestions. Mike emphasized the importance of knowing what data the AI is trained on.
“If you don’t know what data the AI was fed, you can’t know what it considered in its recommendation.”
AI as a Partner, Not a Replacement
Rather than viewing AI as a competitor, Mike encourages clinicians to see it as a collaborator, like a second brain or an extra set of hands.
“It’s not about replacing clinicians; it’s about helping them work at the top of their skill set.”
He also stressed the importance of using AI incrementally. Not every visit needs a scribe and not every workflow needs automation. The key is to choose the right tool for the task.
Looking Ahead: Smarter Systems, Better Outcomes
Mike sees a future where EMRs are more connected, more intelligent, and more supportive of proactive care. But he also acknowledges the challenges—especially around data privacy, interoperability, and change management.
Still, he’s optimistic:
“This is the first time I really feel like I’m in the future. This technology feels like it will change things, hopefully for the best, and I’m excited to be here for it.”
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By Mike Checkley, President Accuro and Dr Dimitre Ranev